Assessing the Implementation of Dashboards to Increase Adherence and Reduce Inpatient Fall

Abstract

Problem: Inpatient falls remain a major challenge in healthcare. In a community teaching hospital on a medical/surgical unit (21 beds), in Fiscal year 2022 11.6% (N total=23) of the falls recorded were classified as repeat falls. Falls impact the patients, patient’s families, healthcare workers, and the facility. Purpose: This quality improvement project aims to assess and evaluate the effectiveness of dashboards in increasing adherence rates with evidence-based fall prevention strategies and reducing the inpatient rate of falls. Methods: A 15-week (n =21) clinical audit was conducted weekly, using evidence-based audit criteria tailored to the unit's needs. The project lead performed clinical audits, reviews, discussions, and re-audits in sequence to increase the adherence rate and improve clinical practice in evidence-based fall prevention strategies. A dashboard of the weekly clinical audit was posted on the unit’s information board. The project lead reviewed the dashboard with a less than 80% adherence rate with fall prevention strategies for discussion with nursing staff biweekly. Results: The clinical audit criteria were grouped into two categories on the dashboard: ‘admission, transfer, and shift documentation’ and ‘care plan documentation’. The results of the adherence rate for ‘admission, transfer, and shift documentation’ in the 15 weeks of implementation range between 34% - 100% (n=129). The results of the adherence rate for the ‘care plan documentation’ ranges from 9% to 90% (n=129). However, there were only four falls recorded since the start of this project (2.89%) compared to 11.3% in 2022 the same period. Conclusion: This project used a dashboard with pre- and post-clinical audit strategies to translate evidence into promoting improved practice with fall prevention strategies. The data shows an increase in adherence rate of the ‘care plan documentation’ audit criteria and some of the other evidence-based fall prevention strategies; however, the run chart did not show any evidence with the reduction in the rate of falls.